Provider Demographics
NPI:1437433729
Name:DIFORMATO, JOANNE (RPH)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:DIFORMATO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 JAMES L REDMAN PKWY
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-7107
Mailing Address - Country:US
Mailing Address - Phone:813-752-2672
Mailing Address - Fax:
Practice Address - Street 1:2202 JAMES L REDMAN PKWY
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-7107
Practice Address - Country:US
Practice Address - Phone:401-741-0608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH040811835P1200X
CTPCT.00091681835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy